State-of-the-art surgical robot crosses 500 colorectal cancer patient treatment milestone

More than 500 patients have now benefitted from even more precise colorectal cancer surgery thanks to a state-of-the-art surgical robot at University Hospitals of North Midlands NHS Trust (UHNM).

The intuitive Da Vinci Xi dual console robotic system was funded by the Denise Coates Foundation as part of their support for the development of the Trust's cancer services which has been delivered via an £8.4 million grant to UHNM Charity.

The system enables surgeons to perform advanced robotic procedures using cutting-edge technology.

Mr Philip Varghese is consultant colorectal surgeon and lead for colorectal robotic surgery programme at UHNM. As robotic proctor he is involved in training colorectal surgeons nationally and internationally.

 Mr Varghese said: “This state-of-the-art system helps us to take patient care to the next level at UHNM. Reflecting on our colorectal cancer programme since its start in 2017, I am delighted that so many of our patients requiring colorectal cancer surgery have benefitted from the outstanding care made possible thanks to the robotic system.

“The highly-magnified 3DHD vision with true depth perception, allows our surgeons to have an immersive experience able to see tissue planes clearly, identify structures and stay oriented in the anatomy.

“We are able to perform re-joining of bowel (anastomosis) with higher confidence knowing there is adequate blood flow. The Firefly Fluorescence imaging system used in conjunction with an injectable flurescence-Indocyanine Green (ICG) dye, enables our surgeon to do real-time visualisation of blood flow, vessels, tissue perfusion and mapping of lymph nodes by switching between standard visible light and near-infrared imaging. Tissue with blood flow is highlighted in a green colour and areas with decreased and compromised blood flow appearing grey.”

UHNM is one of the leading centres in the UK with expertise in offering robotic surgical procedures. Since the inception of the robotic programme in 2014, almost 2,500 major robotic surgical procedures have been undertaken by surgeons in Urology, Colorectal, and Gynaecology.

Mr Varghese added: “We also have advanced ultrasound probes that can be used intraoperatively, enabling targeted advanced cancer surgery, mapping of vessels, localisation of difficult to locate lymph nodes, identifying small tumour in the kidney, pancreas, and liver.

“The robotic system also includes integrated table motion to dynamically control patient position during surgery. The system has a secure digital hub connectivity which enables procedures to be captured for training and review.

“We currently have eight our colorectal surgeon fully trained in undertaking robotic surgical procedures. Our aspiration is to become a leading robotic colorectal unit nationally with all 12 colorectal surgeons fully trained in using the advanced minimally invasive Da Vinci robotic surgery platform.”

“We are passionate in training the next generation of robotic surgeons.”

UHNM's robotic colorectal unit will be soon be starting robotic training for Colorectal trainees under Health Education England (HEE) West Midlands.

The integrated SimNow robotic simulation system with 47 skills exercises and over 30 procedure simulations provides surgeons with specialised content to support their learning over time. The dual console also enables training of surgeons and higher surgical trainees which then facilitates joint operating for complex procedures.

Beryl Gwilt, 76, from Tittensor underwent robotic surgery with Mr Varghese for bowel cancer at Royal Stoke following a 14 weeks treatment with chemoradiotherapy to shrink her cancer.

She said: “Prior to my operation Mr Varghese explained to me that the surgery would be carried out using robotics and I was frightened to death. But everyone said what a good surgeon he was and how well it works so I said yes.

“The outcome was definitely better than I thought it was going to be because you haven’t got all the cuts, it’s only four little round circles. I think it’s amazing how they can go in these little round circles and manage to remove the cancer. The team were marvellous, from the anaesthetist Dr. Hopkins who put me at ease just before the operation, to Mr Varghese who visited me every day I was on the ward recovering.

“The staff on the Gastrointestinal Ward 108 have been wonderful. They’re there as soon as you ask them to do anything and they keep checking on me throughout the day, it’s been really good.”
Yvette Beardmore, 64, of Newcastle-under-Lyme, also underwent robotic surgery for bowel cancer at Royal Stoke.

She said: “I could not fault the care and experience I received having cancer treatment at UHNM. I felt fine going into surgery knowing it was to be carried out using the surgical robot. It helped with a quicker recovery, there was some initial pain and discomfort, but I have benefitted from having the procedure carried out this way.”

The robotic system costing £2 million, is a key part of UHNM's plans to develop state-of-the-art cancer services at the Trust, the total investment of £8.4 million will comprise eight further elements when fully delivered.

Lisa Thomson, Director of Communications and UHNM Charity, said: "We are delighted that so many local people have been able to benefit from the robot and skill of our surgeons. We are extremely grateful for the support of the Denise Coates Foundation who as well as funded a range of activities during the height of the Covid-19 pandemic, continue to help us enhance and develop the best care possible. This funding continues to make a significant difference to both the lives of our staff and our patients."